<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <title>退货</title>

    <!--公用css引用-->
    <?php include 'include/style.php';?>
    <!--END/公用css引用-->
    <link rel="stylesheet" href="../css/userCenter.css">
</head>
<body>

<!--公共头部-->
<?php include 'include/header.php';?>
<!--END/公共头部-->

<div class="inbox user-center">
    <div class="layout-margin unend">
        <div class="sidebar-end"></div>
        <div class="sidebar-start">
            <?php include 'include/leftnav.php';?>
        </div>

        <!--主体部分-->
        <div class="container">
            <div class="container-inner u-order order-comment">
                <div class="ui-brd-box1-">
                    <div class="tit-2 tit-skin-2">
                        <span class="h">申请售后</span>
                    </div>

                    <div class="order-list order-list-big">
                        <table class="bl-table bl-table-tdLi table-tc ui-brd-box1">
                            <tr>
                                <th colspan="2">商品名称</th>
                                <th>包装清单</th>
                                <th>赠品清单</th>
                                <th>数量</th>
                            </tr>
                            <tr>
                                <td class="pic tl">
                                    <a href="#">
                                        <img class="head-img" src="../images/classify/pic-14.jpg" alt="#">
                                    </a>
                                </td>
                                <td class="tl">
                                    <p class="name fn-mb10"><a class="link" href="#">飞科（FLYCO）FR5001充电式毛球修剪器 剃去毛球器</a></p>
                                    <p class="text-color-7">购买时间：2015-12-12<span class="fn-mr10"></span> 00:00:00</p>
                                </td>
                                <td>-</td>
                                <td>-</td>
                                <td>1</td>
                            </tr>
                        </table>

                        <div class="fn-ml10 fn-mr10 fn-mt20">
                            <span class="text-color-error">* 温馨提示：</span> 本次售后服务将由 <a href="" class="text-color-error">阿福易购</a> 为您提供
                            <div class="fn-dib hover-show-tip fn-rel fn-fr">
                                <i class="icon icon-qq-blue-sm fn-mr4" style="margin-top: -3px;"></i>
                                联系客服
                                <div class="bl-tip-box tip-skin-gray" style="left: -59px;top:20px;width:120px; ">
                                    <div class="J-box TJ-box" style="left: 50%;"><span class="J"></span><i class="J"></i></div>
                                    <div class="bl-tip-con">
                                        <ul>
                                            <li>
                                                <a class="js-qq" data-qq="3039215126" href="http://wpa.qq.com/msgrd?v=3&amp;uin=3039215126&amp;site=qq&amp;menu=yes" target="_blank" title="在线"><i class="icon fn-mr4 icon-qq-blue-sm" style="margin-top: -3px;"></i>客服-小阿</a>
                                            </li>
                                            <li>
                                                <a class="js-qq" data-qq="1378461406" href="http://wpa.qq.com/msgrd?v=3&amp;uin=1378461406&amp;site=qq&amp;menu=yes" target="_blank" title="在线"><i class="icon fn-mr4 icon-qq-blue-sm" style="margin-top: -3px;"></i>客服-小福</a>
                                            </li>
                                            <li>
                                                <a class="js-qq" data-qq="2151543159" href="http://wpa.qq.com/msgrd?v=3&amp;uin=2151543159&amp;site=qq&amp;menu=yes" target="_blank" title="离线"><i class="icon icon-qq-gray-sm fn-mr4" style="margin-top: -3px;"></i>客服-小易</a>
                                            </li>
                                            <li>
                                                <a class="js-qq" data-qq="3082657948" href="http://wpa.qq.com/msgrd?v=3&amp;uin=3082657948&amp;site=qq&amp;menu=yes" target="_blank" title="离线"><i class="icon icon-qq-gray-sm fn-mr4" style="margin-top: -3px;"></i>客服-小塔</a>
                                            </li>
                                        </ul>
                                    </div>
                                </div>
                            </div>
                        </div>

                        <div class="return-goods fn-mt20">

                            <form class="js-form bl-form bl-formhor" method="post" action="" novalidate="novalidate">

                                <!--信息提交-->
                                <ul class="ul-group">

                                    <li class="bl-form-group">
                                        <label><em class="text-color-6">*</em>服务类型：</label>
                                        <div class="controls">
                                            <div class="fn-dib fn-mt6">
                                                <select required="required" tabindex="-1">
                                                    <option value="1">退货</option>
                                                    <option value="2">换货</option>
                                                </select>
                                            </div>
                                        </div>
                                    </li>
                                    <li class="bl-form-group">
                                        <label><em class="text-color-6">*</em>提交数量：</label>
                                        <div class="controls">
                                            <div class="form-dominput">1</div>
                                        </div>
                                    </li>
                                    <li class="bl-form-group">
                                        <label><em class="text-color-6">*</em>问题描述：</label>
                                        <div class="controls">
                                            <textarea class="fn-textarea" name="content" style="width: 600px;" placeholder="最多500字" maxlength="500"></textarea>
                                        </div>
                                    </li>

                                    <hr class="fn-mb10">
                                    <li class="fn-mb10"><strong class="fn-ml10">确认信息</strong></li>
                                    <li class="bl-form-group">
                                        <label><em class="text-color-6">*</em>申请凭据：</label>
                                        <div class="controls">
                                            <div class="form-dominput">
                                                <label class="fn-mr20">
                                                    <input type="checkbox">
                                                    有发票
                                                </label>
                                                <label>
                                                    <input type="checkbox">
                                                    有检测报告
                                                </label>
                                            </div>
                                        </div>
                                    </li>

                                    <li class="bl-form-group">
                                        <label><em class="text-color-6">*</em>返回方式：</label>
                                        <div class="controls">
                                            <div class="fn-dib fn-mt6">
                                                <select required="required" tabindex="-1">
                                                    <option value="1">快递</option>
                                                    <option value="2">自提</option>
                                                </select>
                                            </div>
                                        </div>
                                    </li>
                                    <li class="bl-form-group">
                                        <label><em class="text-color-6">*</em>收货地址：</label>
                                        <div class="controls">
                                            <input class="fn-tinput fn-tinput-longer" required="" name="address" type="text" value="" placeholder="收货地址">
                                        </div>
                                    </li>
                                    <li class="bl-form-group">
                                        <label><em class="text-color-6">*</em>客户姓名：</label>
                                        <div class="controls">
                                            <input class="fn-tinput" required="" name="name" type="text" value="" placeholder="客户姓名">
                                        </div>
                                    </li>

                                    <li class="bl-form-group">
                                        <label><em class="text-color-6">*</em>手机号码：</label>
                                        <div class="controls">
                                            <input class="fn-tinput" required="" name="Phone" type="text" value="" placeholder="手机号码">
                                        </div>
                                    </li>

                                    <li class="bl-form-group bl-form-btns">
                                        <label class="fn-vhide">提交：</label>
                                        <div class="controls">
                                            <button class="fn-btn btn-primary fn-mr8 btn-save" type="submit">提交</button>
                                        </div>
                                    </li>
                                </ul>

                            </form>

                        </div>

                    </div>
                </div>


            </div>

        </div>
        <!--END/主体部分-->

    </div>
</div>

<!--公共尾部-->
<?php include 'include/footer.php'; ?>
<!--END/公共尾部-->

<!--公用js引用-->
<?php include 'include/script.php'; ?>
<!--END/公用js引用-->

</body>
</html>